38414 Federal Register / Vol. 63, No. 136 /Thursday, July 16, 1998 / Notices

Collection: Medicare+Choice (M+C)

Providers Sponsored Organization

(PSO) Waiver Request Form and

Supporting Regulations in 42 CFR

422.370–422.378; Form Number:

HCFA–R–231; Use: The PSO waiver

request form is for use by PSO’s that do

not have a State risk-bearing entity

licence and that wish to enter into a

M+C contract with HCFA to provide

prepaid health care services to eligible

Medicare beneficiaries. HCFA will use

the information requested on this form

to determine whether the applicant is

eligible for a waiver of the state

licensure requirement for M+C

organizations as allowed under section

1855(a)(2) of the Social Security Act.;

Frequency: One-time.; Affected Public:

Business or other for-profit, Not-forprofit institutions, and Federal

Government.; Annual Number of

Respondents: 30.; Total Annual

Responses: 30.; Total Annual Hours

Requested: 300.

To obtain copies of the supporting

statement and any related forms for the

proposed paperwork collections

referenced above, access HCFA’s Web

Site address at http://www.hcfa.gov/

regs/prdact95.htm, or E-mail your

request, including your address, phone

number, OMB number, and HCFA

document identifier, to

Paperwork@hcfa.gov, or call the Reports

Clearance Office on (410) 786–1326.

Written comments and

recommendations for the proposed

information collections must be mailed

within 30 days of this notice directly to

the OMB desk officer: OMB Human

Resources and Housing Branch,

Attention: Allison Eydt, New Executive

Office Building, Room 10235,

Washington, D.C. 20503.

Dated: July 9, 1998.

John P. Burke III,

HCFA Reports Clearance Officer, HCFA Office

of Information Services, Security and

Standards Group, Division of HCFA

Enterprise Standards.

[FR Doc. 98–19003 Filed 7–15–98; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Care Financing Administration

Privacy Act of 1974; Report of Altered

Systems

AGENCY: Department of Health and

Human Services (HHS), Health Care

Financing Administration (HCFA).

ACTION: Notice of the global addition of

three new routine uses to designated

HCFA Systems of Records.

SUMMARY: HCFA is adding three

additional routine uses to the Systems

of Records specified in Appendix A.

These routine uses will permit HCFA to

disclose individual-specific information

for the purpose of combating fraud or

abuse in the health benefit programs

administered by HCFA and for other

compatible purposes. These new routine

uses will permit HCFA to make

disclosures as follows: (1) To a HCFA

contractor, including but not necessarily

limited to fiscal intermediaries and

carriers under title XVIII of the Social

Security Act, to administer some aspect

of a HCFA-administered health benefits

program, or to a grantee of a HCFAadministered grant program, which

program is or could be affected by fraud

or abuse, for the purpose of preventing,

deterring, discovering, detecting,

investigating, examining, prosecuting,

suing with respect to, defending against,

correcting, remedying, or otherwise

combating such fraud or abuse in such

program; (2) To another Federal agency

or to an instrumentality of any

governmental jurisdiction within or

under the control of the United States,

including any state or local government

agency, for the purpose of preventing,

deterring, discovering, detecting,

investigating, examining, prosecuting,

suing with respect to, defending against,

correcting, remedying, or otherwise

combating fraud or abuse in a health

benefits program funded in whole or in

part by Federal funds; and, (3) To any

entity that makes payment for or

oversees the administration of health

care services, for the purpose of

preventing, deterring, discovering,

detecting, investigating, examining,

prosecuting, suing with respect to,

defending against, correcting,

remedying, or otherwise combating

fraud or abuse against such entity or the

program or services administered by

such entity, subject to certain

conditions.

EFFECTIVE DATES: HCFA filed an altered

system report with the Chairman of the

Committee on Government Reform and

Oversight of the House of

Representatives, the Chairman of the

Committee on Governmental Affairs of

the Senate, and the Administrator,

Office of Information and Regulatory

Affairs, Office of Management and

Budget (OMB), on June 29, 1998. The

proposed new routine uses will become

effective 40 days from the date the

altered system report is submitted to

Congress and to OMB or 30 days from

the publication of this notice, whichever

is later.

ADDRESSES: The public should address

comments to Phillip L. Brown, Director,

Division of Freedom of Information and

Privacy Office, C2–26–21, 7500 Security

Boulevard, Baltimore, Maryland 21244–

1850. Comments received will be

available for review at this location by

appointment, Monday through Friday 9

a.m.–3 p.m., eastern time zone.

FOR FURTHER INFORMATION CONTACT: Mr.

Nelson Berry, Director, Division of Data

Liaison and Distribution, Office of

Information Services, HCFA, N3–13–15,

7500 Security Boulevard, Baltimore,

Maryland 21244–1850. His telephone

number is (410) 786–0182.

SUPPLEMENTARY INFORMATION: We are

publishing this notice to inform the

public of our intent to add three routine

uses under which HCFA may release

information without the consent of the

individual to whom such information

pertains in order to prevent, deter,

discover, detect, investigate, examine,

prosecute, sue with respect to, defend

against, correct, remedy, or otherwise

combat fraud or abuse in the programs

HCFA administers. Each proposed

disclosure of information under these

routine uses will be evaluated to ensure

that the disclosure is legally

permissible, including but not limited to

ensuring that the purpose of the

disclosure is compatible with the

purpose for which the information was

collected. Also, HCFA will require each

prospective recipient of such

information to agree in writing to

certain conditions to ensure the

continuing confidentiality of the

information. More specifically, as a

condition of each disclosure under these

routine uses, HCFA will:

(a) Determine that no other Federal

statute specifically prohibits disclosure

of the information;

(b) Determine that the use or

disclosure does not violate legal

limitations under which the information

was provided, collected, or obtained;

(c) Determine that the purpose for

which the disclosure is to be made;

(1) Cannot reasonably be

accomplished unless the information is

provided in individually identifiable

form;

(2) Is of sufficient importance to

warrant the effect on or the risk to the

privacy of the individual(s) that

additional exposure of the record(s)

might bring;

(3) There is a reasonable probability

that the purpose of the disclosure will

be accomplished;

(d) Require the recipient of the

information to:
Federal Register / Vol. 63, No. 136 /Thursday, July 16, 1998 / Notices 38415

(1) Establish reasonable

administrative, technical, and physical

safeguards to prevent unauthorized

access, use or disclosure of the record or

any part thereof. The physical

safeguards shall provide a level of

security that is at least the equivalent of

the level of security contemplated in

OMB Circular No. A–130 (revised),

Appendix III—Security of Federal

Automated Information Systems which

sets forth guidelines for security plans

for automated information systems in

Federal agencies;

(2) Remove or destroy the information

that allows the subject individual(s) to

be identified at the earliest time at

which removal or destruction can be

accomplished consistent with the

purpose of the request;

(3) Refrain from using or disclosing

the information for any purpose other

than the stated purpose under which the

information was disclosed;

(4) Make no further use or disclosure

of the information except:

(i) To prevent or address an

emergency directly affecting the health

or safety of an individual;

(ii) For use on another project under

the same conditions, provided HCFA

has authorized the additional use(s) in

writing; and,

(iii) When required by law;

(e) Secure a written statement or

agreement from the prospective

recipient of the information whereby the

prospective recipient attests to an

understanding of and willingness to

abide by the foregoing provisions and

any additional provisions that HCFA

deems appropriate in the particular

circumstances; and,

(f) Determine whether the disclosure

constitutes a computer ‘‘matching

program’’ as defined in 5 U.S.C.

552a(a)(8). If the disclosure is

determined to be a computer ‘‘matching

program,’’ the procedures for matching

agreements as contained in 5 U.S.C.

552a(o) must be followed.

The new routine uses established by

this notice are to be considered as the

next three numbers following the

existing enumerated routine uses in

each of the individual systems of

records being affected as listed in

Appendix A. These new routine uses

read as follows:

(1) To a HCFA contractor, including

but not necessarily limited to fiscal

intermediaries and carriers under title

XVIII of the Social Security Act, to

administer some aspect of a HCFAadministered health benefits program,

or to a grantee of a HCFA-administered

grant program, which program is or

could be affected by fraud or abuse, for

the purpose of preventing, deterring,

discovering, detecting, investigating,

examining, prosecuting, suing with

respect to, defending against, correcting,

remedying, or otherwise combating such

fraud or abuse in such programs.

(2) To another Federal agency or to an

instrumentality of any governmental

jurisdiction within or under the control

of the United States, including any state

or local government agency, for the

purpose of preventing, deterring,

discovering, detecting, investigating,

examining, prosecuting, suing with

respect to, defending against, correcting,

remedying, or otherwise combating

fraud or abuse in a health benefits

program funded in whole or in part by

Federal funds.

(3) To any entity that makes payment

for, or oversees the administration of,

health care services, for the purpose of

preventing, deterring, discovering,

detecting, investigating, examining,

prosecuting, suing with respect to,

defending against, correcting,

remedying, or otherwise combating

fraud or abuse against such entity or the

program or services administered by

such entity, provided:

(a) Such entity enters into an

agreement with HCFA to share

knowledge and information regarding

actual or potential fraudulent or abusive

practices or activities regarding the

delivery or receipt of health care

services, or regarding securing payment

or reimbursement for health care

services, or any practice or activity that,

if directed toward a HCFA-administered

program, might reasonably be construed

as actually or potentially fraudulent or

abusive;

(b) Such entity does, on a regular

basis, or at such times as HCFA may

request, fully and freely share such

knowledge and information with HCFA,

or as directed by HCFA, with HCFA’s

contractors; and,

(c) HCFA determines that it may

reasonably conclude that the knowledge

or information it has received or is

likely to receive from such entity could

lead to preventing, deterring,

discovering, detecting, investigating,

examining, prosecuting, suing with

respect to, defending against, correcting,

remedying, or otherwise combating

fraud or abuse in the Medicare,

Medicaid, or other health benefits

program administered by HCFA or

funded in whole or in part by Federal

funds.

These proposed new routine uses are

consistent with the relevant provisions

of the Privacy Act of 1974, as amended,

5 U.S.C. 552a.

Because these proposed routine uses

will significantly alter the systems of

records listed in Appendix A, we are

preparing a report of altered system of

records under 5 U.S.C. 552a(r).

Dated: June 29, 1998.

Nancy-Ann Min DeParle,

Administrator, Health Care Financing

Administration.

Appendix A

09–70–0005 National Claims History

(NCH), HHS/HCFA/BDMS

09–70–0040 Health Care Financing

Administration Organ Transplant Data

File, HS/HCFA/BDMS

09–70–0501 Carrier Medicare Claims

Records, HHS/HCFA/BPO

09–70–0503 Intermediary Medicare Claims

Records, HHS/HCFA/BPO

09–70–0505 Supplemental Medical

Insurance (SMI) Accounting Collection and

Enrollment System (SPACE), HHS/HCFA/

BPO

09–70–0516 Medicare Physician Supplier

Master File, HHS/HCFA/BPO

09–70–0518 Medicare Clinic Physician

Supplier Master File, HHS/HCFA/BPO

09–70–0520 End Stage Renal Disease

(ESRD) Program Management and Medical

Information System (PMMIS), HHS/HCFA/

BDMS

09–70–0524 Intern and Resident

Information System, HHS/HCFA/BPO

09–70–0525 Medicare Physician

Identification and Eligibility System

(MPIES), HHS/HCFA/BPO

09–70–0526 Common Working File (CWF),

HHS/HCFA/BPO

09–70–0527 HCFA Utilization Review

Investigatory Files, HHS/HCFA/BPO

09–70–0529 Medicare Supplier

Identification File, HHS/HCFA/BPO

09–70–1511 Physical Therapists in

Independent Practice (Individuals), HHS/

HCFA/HSQB

09–70–2003 HCFA Program Integrity/

Program Validation Case Files HHS/HCFA/

BPO

09–70–2006 Income and Eligibility

Verification for Medicaid Eligibility

Quality Control (MEQC) Review, HHS/

HCFA

09–70–4001 Group Health Plan (GHP)

System, HHS/HCFA/OMC

09–70–4003 Medicare HMO/CMP

Beneficiary Reconsideration System

(MBRS), HHS/HCFA/OMC

09–70–6001 Medicaid Statistical

Information System (MSIS), HHS/HCFA/

BDMS

[FR Doc. 98–17944 Filed 7–15–98; 8:45 am]

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Health Resources and Services

Administration

Advisory Commission on Childhood

Vaccines Request for Nominations for

Voting Members

AGENCY: Health Resources and Services

Administration, HHS.